Presbyopia-Correcting IOLs: FAQ
The two main types of presbyopia-correcting IOLs are multifocal IOLs and accommodating IOLs. These premium lens implants may offer significant advantages over conventional monofocal IOLs by providing an expanded focal range that enables clear vision at multiple distances for people with presbyopia.
A conventional monofocal IOL usually will provide clear distance vision after cataract surgery, but you will still need reading glasses or computer glasses to see objects at arm's length and closer (unless you choose a monovision correction to aid in your reading vision). Presbyopia-correcting lenses can expand your range of clear vision, allowing you to see well at all distances with reduced need for eyeglasses.
Here are answers to a few frequently asked questions (FAQ) about presbyopia-correcting IOLs:
Why would I want a multifocal IOL or accommodating IOL for cataract surgery?
Most people who undergo cataract removal desire being less dependent on eyeglasses after surgery. Presbyopia-correcting IOLs offer this advantage, including decreasing the need for computer glasses and reading glasses.
But aren't presbyopia-correcting IOLs a lot more expensive? How much extra do I have to pay?
Presbyopia-correcting IOLs are more expensive because they cost more for companies to develop and produce, and because extra surgeon skill is required for a procedure that includes the use of these lenses. Also, extra care must be taken with these lenses to make sure you receive the exact right prescription for your eyes. Costs vary, depending on the lens used, but you can expect to pay up to $2,500 extra per eye. Otherwise, basic costs of cataract surgery are covered by Medicare and most other health insurance policies.
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Why won't Medicare or health insurance cover the full cost of presbyopia-correcting IOLs?
A multifocal or accommodating IOL is not considered medically necessary by insurance companies. Medicare and private health insurance typically will pay only the cost of a basic monofocal intraocular lens and accompanying cataract surgery. Use of a more expensive, presbyopia-correcting IOL is considered an elective luxury like LASIK and PRK, which also typically are not covered by health insurance.
Can my local cataract surgeon perform presbyopia-correcting surgery?
Yes, but you need to make sure that your cataract surgeon has experience with the specific presbyopia-correcting IOL chosen for the procedure. Studies have shown that surgeon experience is a key factor in successful outcomes, particularly in terms of whether you will need to wear eyeglasses following cataract surgery.
What problems are associated with presbyopia-correcting IOLs?
The most common complications of presbyopia-correcting IOLs are:
- Indistinct or "foggy" vision (far away, up close, or both)
- Reduced contrast around objects, making them appear less clearly defined
- Glare and halos around streetlights and vehicle headlights and taillights in low-light conditions
In many cases, these problems may become less noticeable with time without treatment. In other cases, a follow-up refractive procedure such as LASIK, PRK, or a procedure to correct astigmatism called limbal relaxing incisions (LRI) may be needed to improve vision and decrease symptoms.
In a small minority of cases, it could be necessary for your cataract surgeon to remove the presbyopia-correcting IOL and replace it with a different lens implant.
Be sure to thoroughly discuss the advantages and risks associated with presbyopia-correcting IOLs with your cataract surgeon at your preoperative exam and consultation.
Also, be aware that an additional fee often is required for vision enhancement procedures after cataract surgery, and these typically are not covered by Medicare or private health insurance.
How can I improve my chance of a successful outcome if I choose to undergo cataract surgery with a presbyopia-correcting IOL?
Most cataract surgeons are highly skilled when it comes to familiar techniques associated with conventional monofocal IOLs. But if you want a good outcome with a multifocal IOL or accommodating IOL, you should make sure your surgeon is committed to presbyopia-correcting IOL technology and has undergone appropriate training in performing cataract surgery with these premium intraocular lenses.
[Page updated October 2015]